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If you’ve spent some time on our website at
www.plansforhealth.net you know you’ve harnessed a
power tool to quickly compare major California insurance
carrier plans, benefits, and
pricing all instantly and at your fingertips. So,
now that you have pricing and benefit data how do you
use the decision in combination with your personal
situation pick the right plan. Let’s spend a few
minutes considering some of the key factors to think
about when evaluating your next California health
insurance plan.
DEDUCTIBLE VS. PREMIUMS: A
major factor in the monthly premium cost of a health
insurance plan is the deductible. An insurance plan,
you certainly have noticed if you’ve already run your
instant quote, contains higher premiums with lower
deductible insurance coverage. What you need to pay
attention to is typically how much of your plan
deductible might you spend each year. If you are
comparing the difference in cost between a $250
deductible plan vs. a $1000 deductible plan and the
monthly premium for the $250 deductible plan is an extra
$300, you’ll be spending an extra $3600 in premiums to
save the $750 difference in deductible size. This
doesn’t make sense to purchase unless you really need a
tax deduction.
WHERE YOU MIGHT CUT BACK:
Consider how many office visits you and your family have
per year. About half the population doesn’t use their
insurance plan or visits the doctor only for very minor
medical expenses. If you are one of those people who
uses the doctor’s office very infrequently you might
consider a health plan which has limited office visit,
or office visit which applies to the plan’s general
medical deductible. You can often dramatically reduce
monthly premium costs by purchasing a plan which might
office visits capped at 2-3 per member per year. Don’t
get caught up in keeping a $10 or $20 office visit
because that is the coverage you had at your prior
employer. It’s not worth it if your cost is an extra
$200 per month and you only have one or two office
visits per year historically.
WHAT IS COINSURANCE?:
The percentages you see listed on the plans are called
‘coinsurance percentages.’ These are the medical
expense split percentages you pay, sharing the cost with
the insurance carrier. The percentage amount you see is
typically the amount you are responsible to pay after
the plan deductible is paid. If you see a coinsurance
percentage listed as your benefit it usually means the
plan deductible applies, so you have to pay it first,
then you pay the coinsurance percentage up until you
reach the plans annual out of pocket maximum. Once you
hit this annual out of pocket maximum the health
insurance carrier pays 100% of the bills. You do not
pay the coinsurance percentage forever provided you are
receiving treatment within the terms of the coverage
contract. It’s very important then to understand if
your goal is to pay small monthly premiums and cap your
risk on major medical bills how your coinsurance works
in combination with deductible and annual out of pocket
maximum.
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